Upper Limb Tension Test 4

Orthopedic Exam / Special Tests for Physical Therapy: SHOULDER

ULTT 4 – Upper Limb Tension Test 4: ULNAR NERVE

The ulnar nerve passes from the lower nerve roots of the neck (C7-C8-T1), combining and twisting in the brachial plexus, passing through the interscalene triangle, together with the subclavian artery. They then pass behind the collar bone via the “thoracic outlet”, a space bounded by the first rib, clavicle, and the upper lung.

An entrapment in this space is called a thoracic outlet syndrome which is often involved in the shoulder and arm pain syndromes like frozen shoulder; tingling in arms and hands, particularly the pinkie side of the lower arm is common.

The ulnar nerve supplies: (1) the skin of the pinkie and half the ring finger and adjacent hand, (2) the muscles mainly of the pinkie, and one muscle of the thumb, (3) the flexor muscles in the forearm that flex the wrist and fingers.

Special Test: ULTT 4 – Upper Limb Tension Test 4 (ULNAR NERVE)


  •  To test for Ulnar Nerve, C8 and T1 nerve roots and ulnar nerve as the source of the client’s painful shoulder and arm.

Video Demo Instructions, Procedure, Positive Test:

ULTT 4 – Upper Limb Tension Test 4: Video Demo (Procedure below)

ULTT 4 – Upper Limb Tension Test 4: PROCEDURE:

• Patient is supine , with their side being tested at the edge of the table
• Examiner applies a depressive force to the patient’s affected shoulder
• With examiner’s other hand, hold the patient’s wrist and Abduct their affected humerus to 90°
• Examiner slowly flexes patient’s elbow, then supinate their forearm
• Examiner slowly extend patient’s wrist and fingers and deviate the wrist to the radial side.

ULTT 4 – Upper Limb Tension Test 4: POSITIVE TEST:

  • Recurrence of their shoulder and arm pain (numbness, tingling).